Causes

Fistulas are caused by damage to local tissue. It is often associated with cysts or infections of anal glands. A fistula can also be caused by sores, ulcers, or other injuries. It may develop at the same time as these injuries or weeks after infections clear.

In some people, anal fistulas occur spontaneously without any specific cause.

Treatment

If your fistula is caused by an infection or chronic health condition, it may need to be managed before the fistula is repaired. Talk with your doctor about the best treatment plan for you.

A fistula is only cured with surgical repair. Left untreated, some fistulas can cause repeat abscesses or infections. Depending on the severity or location of the fistula, surgery may be straightforward or may need to be done in stages.

Surgical procedures include:

Fistulotomy—A trench is created in the fistula, which allows for healing from the inside out.

Sealant or plug—A substance is used to fill in the fistula. Both ends of the fistula are closed off, allowing it to heal.

Endorectal flap—A flap is created to expose the internal opening of the fistula. The fistula is stitched shut, and then the flap is put back into place.

Ligation of intersphincteric fistula tract (LIFT)—The internal part of the fistula is identified and tied off. Any infected glandular tissue in the anal canal is removed and the fistula is stitched at the external opening.

Fistulectomy—Rarely done, the fistula is completely removed.

Some procedures may affect muscles that open and close the anus. Depending on your treatment, you may have some degree of fecal incontinence.

Medication may help manage pain and treat any infection. Stool softeners, fiber, or bulk laxatives may also be recommended to decrease strain during bowel movements.

Prevention

To reduce your chance of developing an anal fistula, be sure to manage any health conditions that increase your risk of infections.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.